Provider Demographics
NPI:1518975531
Name:TRAN, ANTHONY (OD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E BELT LINE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2255
Mailing Address - Country:US
Mailing Address - Phone:469-272-3937
Mailing Address - Fax:469-272-3940
Practice Address - Street 1:105 E BELT LINE RD STE 500
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2255
Practice Address - Country:US
Practice Address - Phone:469-272-3937
Practice Address - Fax:469-272-3940
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06264TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U92730Medicare UPIN